First-Time Blood in Stool: Causes and Concerns - Surgery

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First-time rectal bleeding?


This morning, I had a bowel movement like usual, but today I experienced something similar to constipation (I’m not sure, but it felt like my stool was stuck at the opening, and no matter how hard I tried, it wouldn’t come out.
I sat on the toilet for 10 minutes and eventually had a bowel movement, but when I got up, I saw bright red blood in the toilet, and there were drops of blood next to it...
I was really scared.
This is the first time this has happened, and my stool looked like small pellets, similar to rabbit droppings.
When I wiped, the toilet paper was covered in bright red blood.
The second and third times I wiped, there was no blood, and then less than 30 minutes later, I had another bowel movement.
This time it was smooth, and the amount was the same as usual, with no blood.
Doctor, what is going on with me?? Was the first stool very dry and hard?? I usually drink a lot of water.
What should I do??

Cheng Cheng, 20~29 year old female. Ask Date: 2017/10/12

Dr. Ke Fangxu reply Surgery


This situation is likely indicative of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a major concern.
It is recommended to avoid constipation during this period and to shorten the time spent on the toilet.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths may help alleviate symptoms, and over-the-counter hemorrhoid suppositories can be used.
It is best to avoid taking laxatives indiscriminately.
If bleeding persists, it is advisable to consult a physician for evaluation.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2017/10/12

More Info


Experiencing blood in your stool for the first time can be alarming, and it's understandable that you're feeling scared and confused. Let's break down the potential causes and concerns associated with this situation.

Firstly, the presence of bright red blood in your stool can often indicate bleeding from the lower gastrointestinal tract, which includes the rectum and anus. The fact that you mentioned experiencing hard, pellet-like stools suggests that you may be dealing with constipation. When stools are hard and difficult to pass, they can cause small tears in the lining of the anus, known as anal fissures. These fissures can lead to bleeding, especially when straining during a bowel movement. This is a common cause of bright red blood on toilet paper or in the toilet bowl.

Another possibility is hemorrhoids, which are swollen blood vessels in the rectal area that can become inflamed and bleed, particularly during bowel movements. Hemorrhoids can be internal or external, and they often cause discomfort, itching, or a feeling of fullness in the rectal area. If you were straining due to hard stools, this could have exacerbated any existing hemorrhoids, leading to the bleeding you observed.

It's also worth noting that while the presence of blood can be concerning, if the bleeding was minimal and stopped after your initial bowel movement, it may not indicate a serious condition. However, if you experience persistent bleeding, significant pain, or changes in your bowel habits, it is crucial to seek medical attention.

In terms of your diet and hydration, you mentioned that you usually drink plenty of water, which is great. However, it's also important to ensure that your diet is rich in fiber. Foods such as fruits, vegetables, whole grains, and legumes can help soften your stools and promote regular bowel movements. If you're experiencing constipation frequently, consider increasing your fiber intake gradually and incorporating physical activity into your routine, as both can help improve bowel function.

If this is a one-time occurrence and you are otherwise feeling well, it may not be a cause for immediate concern. However, if you notice blood in your stool again, or if you have any other symptoms such as abdominal pain, changes in your bowel habits, or weight loss, it's essential to consult a healthcare professional for a thorough evaluation. They may recommend tests such as a colonoscopy or other imaging studies to rule out any underlying conditions.

In summary, while the presence of blood in your stool can be alarming, it is often related to benign issues such as anal fissures or hemorrhoids, especially if accompanied by hard stools. Maintaining a high-fiber diet, staying hydrated, and avoiding straining during bowel movements can help prevent future occurrences. However, do not hesitate to seek medical advice if the bleeding continues or if you have any concerns about your health. Your well-being is important, and a healthcare provider can offer personalized guidance and reassurance.

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